Organization Active NPI

Satilla Cancer Treatment Centers, LLC

  • Radiation Oncology Physician
  • Dublin, GA
National Provider Identifier
1336477934
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
SATILLA CANCER TREATMENT CENTERS, LLC
Practice address
2406 Bellevue Avenue
#7
Dublin, GA 31021-0000
Phone
(478) 272-2255
Fax
(478) 275-9134
NPI assigned
Nov 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacqueline Lillicotch
Title
Credentialing Officer
Phone
(478) 272-2255

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X Primary

Addresses

Primary practice location

2406 Bellevue Avenue
#7
Dublin, GA 31021-0000

Mailing address

2406 Bellevue Avenue
#7
Dublin, GA 31021-0000
Phone (478) 272-2255

National Provider Directory

National Provider Directory

Locations

1400 Peterson Ave N
#10
Douglas, GA 31533
Phone (912) 383-0815

2406 Bellevue Rd
#7
Dublin, GA 31021
Phone (478) 272-2255

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349136000000",
    "number": "1336477934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 BELLEVUE AVENUE",
            "address_2": "#7",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210000",
            "telephone_number": "478-272-2255",
            "fax_number": "478-275-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2406 BELLEVUE AVENUE",
            "address_2": "#7",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210000",
            "telephone_number": "478-272-2255",
            "fax_number": "478-275-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SATILLA CANCER TREATMENT CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-20",
        "last_updated": "2012-10-02",
        "status": "A",
        "authorized_official_last_name": "LILLICOTCH",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CREDENTIALING OFFICER",
        "authorized_official_telephone_number": "478-272-2255"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.